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Association of Blood Pressure with Prostate Cancer Risk by Disease Severity and Prostate Cancer Death
Department of Clinical Sciences Lund, Lund University, Lund, Sweden.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Medicine. Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.ORCID iD: 0000-0001-6808-4405
Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
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2022 (English)In: Cancer Epidemiology, Biomarkers and Prevention, ISSN 1055-9965, E-ISSN 1538-7755, Vol. 31, no 7, p. 1483-1491Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The association of blood pressure (BP) with prostate cancer risk after accounting for asymptomatic prostate-specific antigen (PSA) testing, and with prostate cancer death, is unclear.

METHODS: We investigated BP, measured at a mean age of 38 years among 430,472 men from five Swedish cohorts, in association with incident prostate cancer (n = 32,720) and prostate cancer death (n = 6718). HRs were calculated from multivariable Cox regression models.

RESULTS: Increasing systolic and diastolic BP levels combined were associated with a slightly lower prostate cancer risk, with a HR of 0.98 (95% CI, 0.97-0.99) per standard deviation (SD) of mid-BP (average of systolic and diastolic BP). The association was restricted to the PSA era (1997 onwards, HR, 0.96; 95% CI, 0.95-0.98), to diagnoses initiated by a PSA test in asymptomatic men (HR, 0.95; 95% CI, 0.93-0.97), and to low-risk prostate cancer (HR, 0.95; 95% CI, 0.92-0.97). There was no clear association with more advanced disease at diagnosis. In cases, a slightly higher risk of prostate cancer death was observed for higher BP levels (HR, 1.05; 95% CI, 1.01-1.08) per SD of mid-BP; however, the association was restricted to distant metastatic disease (Pheterogeneity between case groups = 0.01), and there was no association for BP measured less than 10 years prior to diagnosis.

CONCLUSIONS: Prediagnostic BP is unlikely an important risk factor for prostate cancer development and death. Less asymptomatic PSA testing among men with higher BP levels may explain their lower risk of prostate cancer.

IMPACT: Elevated BP is unlikely to be an important risk factor for prostate cancer.

Place, publisher, year, edition, pages
2022. Vol. 31, no 7, p. 1483-1491
National Category
Cancer and Oncology
Identifiers
URN: urn:nbn:se:umu:diva-198223DOI: 10.1158/1055-9965.EPI-22-0159ISI: 000823311200001PubMedID: 35511742Scopus ID: 2-s2.0-85133980998OAI: oai:DiVA.org:umu-198223DiVA, id: diva2:1684144
Funder
Swedish Research Council, 2017-00650Swedish Research Council, 2015-02332Swedish Research Council, 2018-02825Swedish Cancer Society, 2017/1019Available from: 2022-07-21 Created: 2022-07-21 Last updated: 2023-05-24Bibliographically approved

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Häggström, ChristelStattin, PärJärvholm, Bengt

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